Proggresive muscle weakness/stiffness with swallowing problems

Patient

Q: Five years ago I started have swallowing problems. Tongue won't move drinks or some solids to back of throat. I end up spitting it out or coughing. I also have laryngospasm that happen once twice a month out of the blue. In the past two years I have balance issues and dizziness. If I walk too close to someone and bump into them I almost fall over and become very unsteady. Now for the past year an half the muscles in my body are usually tight. Even at night when just laying around watching tv, I have to remind myself to loosen up. But it's hopeless because as soon as I do try legs, trunk,neck,shoulder and jaw stiffen back up. I feel stiff all the time This causes sever fatigue to set in. I have a great deal of trouble standing or being on my feet for more then two hours. Last week my right thumb started rolling back and forth, it lasted for two weeks then subsided. I know this sounds like a lot but I'm only 52 female and my 84 mother gets around better then I do. This has cause depression to set in. One more thing please, when holding something with wieght for a time, my arms are so weak that I can not hold a Q-tip up to my face. Any advice would be great.

Doctor

A:    The progressive muscle weakness/stiffness that you described, starting with the difficulty with swallowing, then balance issues and fatigue of the rest of the muscles, for sure require a thoroughly neurologic evaluation, including physical exam, lab tests, electro physiologic studies and imaging tests to rule out some neuromuscular diseases or collagen disorders that might cause the symptoms that you have described above.

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